Peritoneal tuberculosis (TB) is a rare extra-pulmonary presentation of TB, caused by strains of mycobacteria, usually Mycobacterium tuberculosis. The clinical presentation of peritoneal TB can be extremely varied, making it a huge diagnostic challenge. Herein, we report a case of a 62-year-old Chinese female with no previous exposure to TB, presenting with 1-day history of per-rectal bleeding and abdominal pain. The diagnosis was eventually made with a combination of blood investigations, computerized tomography scans and histological analysis of peritoneal nodules found on diagnostic laparoscopy, which confirmed necrotizing granulating inflammation. She was subsequently started on anti-TB medications promptly without any further complications and recovered uneventfully.